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Defensive medicine is something the public seems to be very aware of, according to a Wall Street Journal Online/Harris Interactive poll. More than half of adults in the United States say that they've declined treatment recommended by their physician because they felt it was unnecessary.... Pay-for-performance initiatives got a boost from the National Committee for Quality Assurance when, Margaret E. O'Kane, that organization's president, called on Congress to adopt P4P programs for Medicare. O'Kane told the Medicare Payment Advisory Committee (MedPAC) on Sept. 9 that the private sector has seen quality improvement and savings of between 10 percent and 15 percent thanks to P4P programs.